Current practice of surgery for benign goitre—an analysis of the prospective DGAV StuDoQ|Thyroid registry

  • Background: To evaluate the current indications, resection strategies and short-term outcomes of surgery for benign goitre in a country with endemic goitre. Methods: Data of patients who underwent surgery for benign goitre were retrieved from the prospective StuDoQ/Thyroid registry and retrospectively analysed regarding the patient’s demographics, indications for surgery, surgical procedures, histology, and perioperative outcomes. Results: In a 15-month period, 12,888 patients from 83 departments underwent thyroid resections for benign conditions. Main indications for surgery were exclusion of malignancy (68%), compression symptoms (20.7%) and hyperthyroidism (9.7%). Preoperative fine needle aspiration cytology was performed in only 12.2% of patients with the indication "exclusion of malignancy". Thyroidectomy (49.8%) or hemithyroidectomy (36.9%) were performed in 86.7% of patients. Minimally invasive or alternative surgical techniques were applied in only 2.2%. Intraoperative neuromonitoring was used in 98.4% of procedures, in 97.5% of patients at least one parathyroid gland was visualized, and in 15.3% of patients parathyroid tissue was autografted, respectively. The rates of unilateral and bilateral transient recurrent nerve palsy were 3.6% and 0.07% of nerves at risk, the rate of transitory hypoparathyroidism was 15.3%. The rates of postoperative bleeding and wound infections requiring reoperation were 1.4% and 0.07%, respectively. Conclusions: The indication "exclusion of malignancy" is made too liberally, and there is a strong attitude to perform complete thyroid resections. Postoperative hypoparathyroidism is the major complication after surgery for benign thyroid disease, thus requiring more awareness.

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Author:Detlef K. Bartsch, Cornelia Dotzenrath, Christian Vorländer, Andreas Zielke, Theresia Weber, Heinz J. Buhr, Carsten Klinger, Kerstin Lorenz
Pubmed Id:
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
Year of Completion:2019
Date of first Publication:2019/04/08
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Contributing Corporation:StuDoQ/Thyroid Study Group
Release Date:2019/05/02
Tag:hypoparathyroidism; indication; recurrent laryngeal nerve palsy; registry; thyroid resection
Issue:4, Art. 477
Page Number:10
First Page:1
Last Page:10
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0